SHU DONG (N.P.) – Nurse Practitioner, NPI 1376842005
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for SHU DONG (N.P.)
12359 MALKI RD
BANNING, CA 922206974
Phone: (951) 922-2058
Fax: (888) 551-2116
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-12-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 6 Medicare enrollment records; no due dates published yet.
Enrollment records
6
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130814000872 | I | Nurse Practitioner | CA | TBD |
| I20240104003491 | I | Nurse Practitioner | FL | TBD |
| I20240213000941 | I | Nurse Practitioner | TX | TBD |
| I20240423004096 | I | Nurse Practitioner | NY | TBD |
| I20241121002026 | I | Nurse Practitioner | PA | TBD |
| I20241216002138 | I | Nurse Practitioner | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 473 | 435 | $0 |
Insurance plans in this area (ZIP 92220)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NJ | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | GA |
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